"When families understand what will happen during a euthanasia appointment, the fear decreases and the goodbye becomes less chaotic."— Dr. Michael LoSasso, DVM
Episode summary
This is one of the most emotionally significant episodes in the series. Dr. LoSasso brings clarity and compassion to one of the hardest experiences a family can face — saying goodbye to a pet — and specifically addresses how to include children in that process without causing lasting fear.
He starts with language: the phrase "put to sleep" feels gentle to adults but can be deeply confusing or frightening to young children, linking sleep with death. He recommends clear, calm, honest language instead. He also addresses whether children should be present at all — a decision that depends on age, developmental stage, and individual needs, not a universal rule.
Dr. LoSasso then walks through the medical process itself, demystifying it. Many euthanasias use sedation first, followed by an anesthetic injection (often propofol — the same medication used in human surgery prep). At that point, the pet is fully unaware. This stage can be an appropriate moment for younger children to say goodbye without witnessing the final injection.
He also covers guilt — one of the most common experiences families face — and the importance of community resources, grief support, and in-home euthanasia services for families who prefer a quieter setting.
"The decision belongs to the family. My role is to advocate for the patient and explain when euthanasia is the kindest option. Reducing guilt often begins with acknowledging reality: suffering is real, comfort is a gift, and love sometimes means letting go."— Dr. Michael LoSasso, DVM
Language that helps children
Avoid "put to sleep" — this phrase can make young children afraid of going to sleep themselves. Use honest, age-appropriate language: "the medicine will stop his heart and he will die peacefully." Clear language protects a child's sense of safety while honoring the truth. Ask your veterinarian to help you find the right words.
Questions answered in this episode
The following questions are answered by Dr. LoSasso in this episode, drawn directly from the conversation. These are real clinical answers from a practicing emergency veterinarian with 30+ years of experience.
Dr. LoSasso says this is never a one-size-fits-all decision. Age and developmental stage shape how children process loss. Many children benefit from the chance to say goodbye and it can provide closure; others may be better served by saying goodbye before the final injection. He encourages parents to view the moment through their child's eyes and have an honest conversation with the veterinary team about how to structure the visit for their family's specific needs.
Dr. LoSasso explains that while 'put to sleep' feels gentle to adults, it can confuse or frighten young children by linking sleep with death — causing children to become afraid of going to sleep themselves. He recommends clear, calm, honest language instead: explaining that the medicine will stop the pet's heart peacefully, that the pet won't feel any pain, and that it's the kindest thing we can do when an animal is suffering. Clarity protects children's sense of safety.
Dr. LoSasso demystifies the process: many euthanasias begin with sedation to make the experience more gradual and peaceful. A key step is an anesthetic injection — often propofol, the same medication used to prepare human patients for surgery. At that point, pets are fully anesthetized and unaware. The final injection is then administered. He says families can choose to step out after sedation, and many clinics provide quiet rooms and simple supports so adults can focus on the farewell.
Dr. LoSasso says guilt is one of the most common experiences families face. He tries to frame the roles clearly: the decision belongs to the family, while his role is to advocate for the patient and explain when euthanasia is the kindest option. He frames it similarly to decisions around human life support — a profound act of stewardship. He emphasizes that suffering is real, comfort is a gift, and love sometimes means letting go. Support in these moments means giving families time, answering questions, and allowing meaningful rituals.
Dr. LoSasso says not every case requires an emergency clinic. Many communities have mobile veterinarians who specialize in house-call euthanasia — ideal for pets who cannot travel comfortably, large dogs, cats who panic in carriers, or families who want a quieter environment. He wrote a book on this topic in 2012, encouraging families to think through these preferences while the pet is still healthy: location, who should be present, aftercare. Having these answers ready prevents crisis decisions at 2 a.m.
JulieHow do you and your team support pet parents and children during the euthanasia process?
Dr. LoSassoThe presence of children during euthanasia is very much a family decision. Planning in advance helps bring down the emotion a bit — if you've thought about whether the kids should be involved, whether you've talked to them about what's going to happen. It really depends on the age. Preschool kids and high school students comprehend what's happening very differently. I encourage people to consider the process from the child's point of view. Many children have every need and right to say goodbye.
Dr. LoSassoThe danger is the phrase 'put to sleep.' Even the veterinary community is guilty of using it. When you use that phrase with children, it's not accurate — we're not putting anything to sleep. And if you use it with kids, you can make them afraid to go to sleep themselves. You create this really scary thing around sleep. So not only is it not accurate, it's potentially harmful.
Dr. LoSassoThe euthanasia process itself can take as little as two to three minutes. But a lot of times we sedate first so it becomes more of a gradual process. That gives parents who have kids with them an opportunity for younger children to say goodbye without being there for the very end. Then there's propofol — Michael Jackson made it famous, but it's not a sleep aid, it's an anesthetic drug. I've had it myself almost a dozen times. It's a wonderful, smooth anesthetic. It's what we use to get patients prepared for surgery. When we give that, they are anesthetized, not aware — but not actually gone yet in 99% of cases. That's often when families with younger children have those kids say goodbye. The pet is no longer moving, no longer aware, and then the parent can step out with them.
Dr. LoSassoSometimes entire families say goodbye at the propofol stage and all leave together. For really little kids, we bring coloring books and simple activities — they're not really aware of what's happening or don't understand the impact. If my social worker is there, she'll sometimes take those children into her office. Teenagers are largely treated as adults — they need that closure.
JulieHow do you support parents struggling with guilt over making this decision?
Dr. LoSassoIt weighs very heavily on the owners. I don't shoulder it because it's not my decision. My job is to advocate for that patient, and if what they're doing is the right thing, then it's not challenging for me to say: you're making a good decision here, you've done everything that makes sense, and now the kindest thing you can do — as hard as it is — is to say goodbye. I think euthanasia is often much harder on the families than on the pet. It's like making the decision to take a parent or grandparent off life support — you end up in a role of power and responsibility you're not really comfortable with. We give people as much time as they need. Sometimes a partner goes to McDonald's and brings something entirely inappropriate for the dog — and at that point it doesn't matter. We'll give them candy bars. We'll give them chocolate to feed the dogs.
Dr. LoSassoWe don't offer in-home euthanasia ourselves — I don't have the staff. But we have four practices in our area that do nothing else: strictly in-home euthanasia. We give that information to anybody for whom that might be a better option. A big dog diagnosed with a splenic mass or lymphoma where we know the decision needs to be made in 24 to 48 hours — take them home, let the kids spend time with them, say goodbye in your own home where you're comfortable. If you've got a 175-pound Great Dane who's not very mobile, getting him in the car is a barrier. We absolutely support those practices.
Dr. LoSassoOur social worker calls everybody the day after to see how they're doing. We have a monthly pet loss support group meeting for people really having trouble processing the loss. The crematorium we work with has resources and a phone number you can call 24 hours a day. In my opinion, helping a family say goodbye is probably the most important thing a veterinarian does for them.